Psychological Impact of Testing Positive for Human Papillomavirus at Cervical Cancer Screening

In the UK and elsewhere, cervical cancer screening has changed to incorporate primary human papillomavirus (HPV) testing. This means all women who attend screening are told whether they test positive or negative for high-risk HPV. Testing positive for HPV has been associated with elevated anxiety and distress; and can also carry a negative label due to its sexually transmitted nature. Prior to this PhD, there had been no major studies assessing the psychological impact of routine HPV primary screening, or the impact of testing HPV-positive with normal cytology, a result unique to these screening methods. Four studies were conducted: 1) mixed-method systematic review to synthesise emotional response to testing HPV-positive at cervical cancer screening (33 studies); 2) cross-sectional survey comparing anxiety and distress between different test result groups at routine HPV primary screening (n=1127); 3) cross-sectional survey exploring distinct illness representation profiles and anxiety in women testing HPV-positive with normal cytology (n=646); and 4) comparative qualitative interview study to explore reasons for variations in anxiety in women testing HPV-positive with normal cytology (n=30). Overall, testing HPV-positive at cervical screening was sometimes associated with adverse emotional, cognitive, behavioural, and physiological sequelae. These impacts appeared to differentially affect subgroups of the population in terms of intensity, duration, and clinical significance. For women testing HPV-positive with normal cytology, maladaptive illness representations may partially account for clinically significant anxiety. Highly anxious women primarily expressed fear of developing cervical cancer and had concerns about potential relationship infidelity and fertility issues. Cognitive Behavioural Theory and Leventhal’s Common-Sense Model of Self-Regulation were used to formulate overarching findings, providing a preliminary theoretical literature in an otherwise atheoretical domain. The findings of this PhD begin to develop an evidence-base for specific messages which could be used by policymakers in routine patient communication materials, to alleviate unnecessary anxiety at HPV primary screening

B_s Mixing Via ψ K*

The decay mode Bs à ψ K*is suggested as a very good way to measure the Bs mixing parameter xs. These decays can be gathered using a ψ → ℓ+ℓ− trigger. This final state has a well resolved four track decay vertex, useful for good time resolution and background rejection

The Transactivation and DNA Binding Domains of the BPV-1 E2 Protein Have Different Roles in Cooperative Origin Binding with the E1 Protein

AbstractThe bovine papillomavirus E2 transactivator protein enhances the ability of the E1 protein to bind to the viral origin of replication which contains an E1 binding site flanked by two E2 binding sites. To determine which regions and functions of the E2 protein are important for this cooperative interaction, a series of mutated E2 proteins were assayed for their ability to enhance E1 origin-specific binding. Cooperative origin binding required at least one E2 DNA binding site, an intact functional E2 DNA binding domain, and an intact transactivation domain. The hinge region of the E2 proteins was dispensable for this activity. To further examine the role of the E2 C-terminal domain, a series of chimeric proteins were generated that substituted the yeast GAL4 DNA binding domain for the E2 DNA binding domain. These chimeric proteins were able to cooperatively bind to a hybrid origin that contained GAL4 binding sites in place of the E2 binding sites. These studies indicate that the E2 transactivation domain is sufficient for interaction with the E1 protein and that the E2 DNA binding domain is required for interaction with origin DNA sequences

Detecting Cognitive Impairment in Older Adults: a Validation Study of Selected Screening Instruments

The present study investigated the criterion-based validity of the Mini-Mental State Examination (MMSE), the Cognitive Capacity Screening Examination (CCSE), and the Neurobehavioral Cognitive Status Examination (NCSE) in a sample of older adults with suspected cognitive impairment. As cognitive screening tests, the MMSE, CCSE, and NCSE should predict performance relative to a more thorough testing procedure. In the present study, performance on the Halstead-Reitan Neuropsychological Test Battery (HRNTB) was employed as the criterion measure. Scores on the General Neuropsychological Deficit Scale (G-NDS), a global performance measure computed from the HRNTB, served as the standard by which to judge the presence of cognitive impairment. The sensitivity, specificity, and predictive value of each screening test, as well as how well each screening test correlated with the G-NDS, were investigated. Results of this investigation found that, although the MMSE, CCSE, and NCSE were all significantly correlated with the G-NDS, only the NCSE demonstrated an appropriate balance between high sensitivity and specificity. When a rigorous neuropsychological evaluation was employed as the criterion standard, the NCSE accurately detected the presence of cognitive impairment: in 82% of the cases. The MMSE and CCSE, however, failed to detect cognitive deficits in approximately 80% of the cases. These findings strongly suggest that the MMSE and CCSE may have limited utility in the identification of cognitive impairment in older adults. The heightened sensitivity of the NCSE appears to be the result of several unigue features of the instrument, including a multidimensional scoring system and a graded series of increasingly difficult items within each ability area. Future studies need to examine the utility of the NCSE in other geriatric settings, as well as with more diverse populations suffering from a variety of organic mental syndromes

Studies on enzyme distribution in subcellular particles of liver and thyroid

Call number: LD2668 .T4 1969 M3Master of Scienc

Lymphatic filariasis in mainland South-East Asia: a systematic review and meta-analysis of prevalence and disease burden

Accurate prevalence data are essential for the elimination of lymphatic filariasis (LF) as a public health problem. Despite it bearing one of the highest burdens of disease globally, there remains limited reliable information on the current epidemiology of filariasis in mainland Southeast Asia. We conducted a systematic review and meta-analysis of available literature to assess the recent and current prevalence of infection and morbidity in the region. Fifty-seven journal articles and reports containing original prevalence data were identified, including over 512,010 participants. Data were summarised using percentage prevalence estimates and a subset combined using a random effects meta-analysis by country and year. Pooled estimates for microfilaraemia, immunochromatographic card positivity and combined morbidity were 2.64%, 4.48% and 1.34% respectively. Taking into account pooled country estimates, grey literature and the quality of available data, we conclude that Lao People's Democratic Republic (PDR), Myanmar and Northeast India demonstrate ongoing evidence of LF transmission that will require multiple further rounds of mass drug administration. Bangladesh, Malaysia, Thailand and Vietnam appear close to having eliminated LF, whilst Cambodia has already achieved elimination status. We estimate that the burden of morbidity is likely high in Thailand; moderate in Cambodia, Myanmar, and Northeast India; and low in Bangladesh. There was insufficient evidence to accurately estimate the disease burden in Lao PDR, Malaysia or Vietnam. The results of this study indicate that whilst considerable progress toward LF elimination has been made, there remains a significant filariasis burden in the region. The results of this study will assist policy makers to advocate and budget for future control programs

Faecal shedding, alimentary clearance and intestinal spread of prions in hamsters fed with scrapie

Shedding of prions via faeces may be involved in the transmission of contagious prion diseases. Here, we fed hamsters 10 mg of 263K scrapie brain homogenate and examined the faecal excretion of disease-associated prion protein (PrPTSE) during the course of infection. The intestinal fate of ingested PrPTSE was further investigated by monitoring the deposition of the protein in components of the gut wall using immunohistochemistry and paraffin-embedded tissue (PET) blotting. Western blotting of faecal extracts showed shedding of PrPTSE in the excrement at 24–72 h post infection (hpi), but not at 0–24 hpi or at later preclinical or clinical time points. About 5% of the ingested PrPTSE were excreted via the faeces. However, the bulk of PrPTSE was cleared from the alimentary canal, most probably by degradation, while an indiscernible proportion of the inoculum triggered intestinal infection. Components of the gut-associated lymphoid tissue (GALT) and the enteric nervous system (ENS) showed progressing accumulation of PrPTSE from 30 days post infection (dpi) and 60 dpi, respectively. At the clinical stage of disease, substantial deposits of PrPTSE were found in the GALT in close vicinity to the intestinal lumen. Despite an apparent possibility of shedding from Peyer’s patches that may involve the follicle-associated epithelium (FAE), only small amounts of PrPTSE were detected in faeces from clinically infected animals by serial protein misfolding cyclic amplification (sPMCA). Although excrement may thus provide a vehicle for the release of endogenously formed PrPTSE, intestinal clearance mechanisms seem to partially counteract such a mode of prion dissemination

A principled approach to programming with nested types in Haskell

Initial algebra semantics is one of the cornerstones of the theory of modern functional programming languages. For each inductive data type, it provides a Church encoding for that type, a build combinator which constructs data of that type, a fold combinator which encapsulates structured recursion over data of that type, and a fold/build rule which optimises modular programs by eliminating from them data constructed using the buildcombinator, and immediately consumed using the foldcombinator, for that type. It has long been thought that initial algebra semantics is not expressive enough to provide a similar foundation for programming with nested types in Haskell. Specifically, the standard folds derived from initial algebra semantics have been considered too weak to capture commonly occurring patterns of recursion over data of nested types in Haskell, and no build combinators or fold/build rules have until now been defined for nested types. This paper shows that standard folds are, in fact, sufficiently expressive for programming with nested types in Haskell. It also defines buildcombinators and fold/build fusion rules for nested types. It thus shows how initial algebra semantics provides a principled, expressive, and elegant foundation for programming with nested types in Haskell